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Volume 60, Issue 4
Displaying 1-14 of 14 articles from this issue
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Preface
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[in Japanese]2014 Volume 60 Issue 4 Pages 161
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSDownload PDF (766K)
Secondary publication
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Tomofumi HAMADA, Masahiro NOMURA, Yoshiaki KAMIKAWA, Kazumasa SUGIHARA2014 Volume 60 Issue 4 Pages 162-176
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSBACKGROUND: DF3/MUC1 mucin is expressed in various cancer tissues, and many in vitro studies have suggested that it may play a role in the aggressive behavior of malignant tumors. However, to the best of the authors’ knowledge, the relation between DF3/MUC1 expression and outcomes has not been investigated in patients with oral squamous cell carcinoma （OSCC）. The objective of the present study was to evaluate the prognostic significance of DF3/MUC1 expression in patients with OSCC.
METHODS: The expression profile of DF3/MUC1 in OSCC tissues from 206 patients was examined using immunohistochemistry. Its prognostic significance in OSCC was statistically analyzed on the basis of detailed clinicopathologic factors.
RESULTS: DF3/MUC1 expression significantly correlated with tumor aggressiveness, such as pathologic lymph-node metastasis （P=.002）, advanced tumor stage （P=.02）, diffuse invasion of cancer cells （P=.03）, and vascular invasion （P=.01）. Respectively, the overall survival （OS） and disease-free survival （DFS） rates were significantly worse for patients with DF3/MUC1 expression than those without DF3/MUC1 expression （P=.001 and P=.0003, respectively）. Multivariate analysis demonstrated that DF3/MUC1 expression was an independent prognostic factor for both OS and DFS （P=.04 for both）. In addition, DF3/MUC1 expression was found to be an independent risk factor for subsequent regional lymph-node metastasis （P=.03）.
CONCLUSIONS: Aberrant expression of DF3/MUC1 is an independent prognostic factor indicating a poor prognosis in patients with OSCC. DF3/MUC1 expression is a risk factor for subsequent lymph-node metastasis in patients with OSCC and therefore may represent an indication for elective neck dissection. Patients with OSCC demonstrating positive expression of DF3/MUC1 should be followed up carefully.View full abstractDownload PDF (7251K)
Original articles
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Osamu IWAMOTO, Katsumi IWAYA, Keita TODOROKI, Akihiro KOBA, Makoto KOG ...2014 Volume 60 Issue 4 Pages 177-185
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSWe previously reported that the measurement of type I collagen cross-linked C-telopeptide in urine （u-CTX） is useful for evaluating the risk of developing bisphosphonate （BP） -related osteonecrosis of the jaw （BRONJ）. In this study, we observed fluctuations of the u-CTX value after the withdrawal of BP.
The subjects were 84 patients who were using BP in whom the withdrawal of BP for 3 months was possible. The u-CTX value is expressed as the interquartile range （median ［25% point, 75% point］. The u-CTX value before withdrawal was 59.5 ［36.0, 99.8］ Cr value, and increased to 110.0 ［69.3, 161.5］ Cr value 3 months after withdrawal （p<0.001）. Although we previously presented the cutoff value （98 Cr value） of u-CTX as related to the risk of developing BRONJ, the u-CTX value in this study was lower than the 98 Cr value before withdrawal, and increased to a level higher than the 98 Cr value after withdrawal for 3 months in 35 （56.5%） of 62 patients in the oral administration group, as compared with only 1 （11%） of 9 patients in the injection administration group. Furthermore, this was noted in 19 （47%） of 40 patients in the steroid non-combined use group and only 6 （27%） of 22 patients in the combined use group. Forty-one patients with a u-CTX value of higher than 98 Cr did not develop BRONJ after an extraction. Of the 9 patients with a u-CTX value of less than 98 Cr, 3 developed BRONJ after an extraction.
These results suggest that improvement in the bone metabolic capacity, which was being suppressed by BP, can be detected by measuring the u-CTX value after the withdrawal of BP, and this value might be a useful index to judge the appropriate time for tooth extraction. However, it should be noted that the u-CTX values in patients who received BP injections or the combined use of steroids were low before withdrawal and did not readily increase even after withdrawal.View full abstractDownload PDF (1691K) -
Kanako TSUBOI, Yutaka YAMAZAKI, Makiko ONODERA-KYAN, Kazuhito YOSHIKAW ...2014 Volume 60 Issue 4 Pages 186-192
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSRecently, zoledronic acid was approved for the indication of bone metastasis from solid tumors and multiple myeloma, and the use of bisphosphonates （BP） has been increasing every year. These drugs are associated with a risk of intravenous bisphosphonate-related osteonecrosis of the jaws （BRONJ）. This study was designed to evaluate the treatment and prevention of BRONJ in cancer patients in our hospital. We performed a retrospective analysis of 69 patients treated with intravenous bisphosphonates （IVBPs） during 5 years （2008 through 2012）. Among the 69 patients, 36 had received dental care before treatment with IVBPs and 33 had not received dental care. Of the 36 cases who were provided professional dental care before initiating treatment with IVBPs, none developed BRONJ. Thirteen patients underwent tooth extraction, and none of them had delayed healing. At the first medical examination in our hospital, of the 33 patients who had a prior history of IVBP exposure, 16 （48%） already had BRONJ and 4 （24% 4/17） developed BRONJ thereafter. Of these 20 patients, BRONJ was diagnosed after dental extraction in 11 patients and on spontaneous exposure in 9. Dental evaluation and treatment helped to prevent BRONJ before initiating IVBP treatment.View full abstractDownload PDF (905K)
Case reports
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Akira NAKATA, Masayuki FUKUDA, Takashi YAMASHITA, Takashi HOMMA, Seiic ...2014 Volume 60 Issue 4 Pages 193-198
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSAdenosquamous carcinoma is a malignant tumor that rarely occurs in the oral and maxillofacioal region. We report a case of adenosquamous carcinoma of the lower gingiva. A 81-year-old man visited our hospital because of swelling of the right lower gingiva in November 2009. A hemorrhagic tumor with induration of 41 × 36 mm was found in the right lower molar region, and histopathological examination of a biopsy specimen suggested a diagnosis of adenosquamous carcinoma expressing cytokeratin 7. Imaging studies revealed cervical lymph-node metastases and nodules in the lung. The clinical diagnosis was suspected to belower gingiva carcinoma （T4aN2bM1, Stage IVC） with an abnormally high level of serum carcinoembryonic antigen （CEA, 50.3 ng/mL）. In January 2010, tracheotomy, neck dissection, lower jaw segmental resection, and lower jaw reconstruction using a metal plate and pectoralis major myocutaneous flap were performed with the patient under general anesthesia. The postoperative serum CEA value decreased to 7.5 ng/mL. In the operative specimen, squamous cell carcinoma and a tubular structure were found, and PAS and Alcian blue stain were positive. The final histopathological diagnosis was adenosquamous carcinoma. He was progressing well and discharged without other treatment in February of the same year. Although pulmonary disease was not diagnosed, lung nodules gradually increased, and he died of respiratory failure in September 2012, 32 months after the operation.View full abstractDownload PDF (6187K) -
Shigeru SUZUKI, Takahiro KAMATA, Hiroki OHKUBO, Sachiho NAGASHIO, Yosh ...2014 Volume 60 Issue 4 Pages 199-203
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSOdontogenic myxoma is a relatively rare benign tumor with local invasion. We report a case of odontogenic myxoma arising in the maxilla of a child.
An 8-year-old girl was referred to us to receive treatment for a right maxillary tumor. Diffuse elastic hard swelling was present in the right cheek, right upper molar, and hard palate region. Radiographic and computed tomographic examinations revealed a 48 × 41 × 34 mm mass obliterating the right maxillary sinus, with destruction of the sinus walls. The patient underwent partial maxillectomy followed by cryosurgery under general anesthesia. Histopathological examination showed that the tumor consisted of stellate-or spindleshaped cells in a myxoid matrix. The matrix was positive for Alcian blue stain, and the tumor cells were positive for vimentin and S100 protein. The histopathological diagnosis was odontogenic myxoma. No clinical or radiological recurrence was noted during a follow-up period of 4 years.View full abstractDownload PDF (2481K) -
Go ARAI, Hiroyuki YAMADA, Kazutoshi NAKAOKA, Toshikatsu HORIUCHI, Masa ...2014 Volume 60 Issue 4 Pages 204-208
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSIn this paper, we report the clinical course of a 11-year-old boy with an ameloblastic fibrodentinoma developing in the right side of the mandible. Clinically, there were no specific findings, except for an unerupted right mandibular first molar. Panoramic radiography and dental computed tomography revealed a well-defined radiolucent lesion with small calcified particles in the right side of the mandible. Moreover, an impacted tooth, which appeared to be the unerupted first molar, existed below the radiolucent lesion. A biopsy was performed, and the lesion was histopathologically diagnosed as ameloblastic fibrodentinoma. The tumor was removed with preservation of the impacted tooth under general anesthesia. As of 3 years after surgery, there have been no signs of recurrence, and the impacted tooth has erupted spontaneously in the dentition and functions as the first molar.View full abstractDownload PDF (3495K) -
Yukie KITAMOTO, Katsu TAKAHASHI, Yu ISOBE, Masayuki IKENO, Sayaka MISH ...2014 Volume 60 Issue 4 Pages 209-213
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSFibrous dysplasia is a benign bone disease characterized by fibro-osseous lesions consisting of metaplastic fibrous tissue with immature bone remodeling. It is now thought to be caused by Gs α somatic mutation leading to abnormal development of the osteogenic mesenchymal tissue. In fibrous dysplasia, a majority of fractures occur in femur and tibia, and mandibular fracture is extremely rare. We report a case of mandibular fracture in fibrous dysplasia arising in a 19-year-old man.
The patient underwent open reduction and fixation of the mandibular fracture. He had a good functional occlusion after surgery.View full abstractDownload PDF (2184K) -
Hitoshi FUJII, Shintaro SUZUKI, Reiko KOYAMA, Hidenobu SAKUMA, Haruki ...2014 Volume 60 Issue 4 Pages 214-218
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSThe maxillofacial area is prone to the lodging of foreign objects in tissue, which are often difficult to remove. We describe a patient in whom foreign objects that were lodged deep in facial tissue were removed by using an optical navigational guidance system. An 84-year-old man presented with wounds on his face after falling through a glass door. Computed tomography images showed multiple radiopaque markers in the pterygopalatine fossa and temporal region. An optical navigation system was used to locate the foreign objects, and the glass pieces that were embedded in the skin and deeper tissues were extracted by using a guided navigation system with the patient under general anesthesia. Thus, foreign objects lodged in the maxillofacial area were successfully removed by using a guided navigation system in a minimally invasive manner.View full abstractDownload PDF (2542K) -
Yumiko INOUE, Yoshihiko YOKOE, Hiroki MORI, Maki HANAI, Gaku YAMAMOTO2014 Volume 60 Issue 4 Pages 219-224
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSGoldenhar syndrome is a disease characterized by a mandibular hypoplastic defect as the main sign, associated with a bulbar conjunctiva epidermoid tumor and backbone malformation resulting from the first and second branchial arch syndrome. Approximately 70% of patients present with unilateral symptoms, resulting in facial asymmetry. Since hypoplasia of the mandible is the main feature of this syndrome, mandibular distraction osteogenesis is suitable for treatment of this syndrome.
We describe an 8-year-2-month-old boy with Goldenhar syndrome. His mandible was Type IIa according to the Pruzansky-Kaban classification. We initially perfomed mandibular distraction osteogenesis to acquire facial symmetry. Then, occlusal plane inclination due to the secondary maxillary deformation was prevented by orthodontic treatment. He was followed up for 10 years with no particular relapse.View full abstractDownload PDF (2125K) -
Atsumu KOUKETSU, Fumitaka TERASAWA, Takamasa SHIROZU, Hiroki GOTO, Ats ...2014 Volume 60 Issue 4 Pages 225-228
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSGiant cell tumors of bone rarely occur in facial bones. As compared with other benign tumors, this tumor is aggressive and has a risk of local recurrence and late malignant changes with metastasis. We report a rare case of giant cell tumor in the mandible of a 4-year-old boy. He was referred to our department because of a radiolucent lesion in the right posterior mandible. Clinical examination revealed a diffuse painless swelling on the right side of the mandible. Under a clinical diagnosis of a tumor in the right side of the mandible, the tumor was extirpated. On histopathological examination, the tumor showed a large number of giant cells and proliferation of spindle cells. The patient has shown no evidence of recurrence for 1 year 6 months.View full abstractDownload PDF (5963K) -
Ikuko GOTO, Shungo FURUDOI, Jyunichiro TAKEUCHI, Masaru ISHIDA, Yasuyu ...2014 Volume 60 Issue 4 Pages 229-233
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSWe report a case of methotrexate-associated lymphoproliferative disorder （MTX-LPD） with osteonecrosis of the maxilla. A 74-year-old woman who had been treated for 10 years with methotrexate （MTX） and steroids for rheumatoid arthritis was found to have pain after tooth extraction of the left upper cuspid. We performed a computed tomographic examination and a biopsy, and the pathological diagnosis was granulation tissue formation. We diagnosed this lesion as incomplete healing after extraction, and followed up the patient with oral management. However, the patient’s symptoms suddenly worsened, and we performed another biopsy for a suspected tumor. The pathological diagnosis was MTX-LPD. The local pain disappeared after MTX therapy was stopped. On the 35th day after discontinuation, a sequestrum was isolated from the maxilla under local anesthesia. After the operation, the wound was covered with mucosal epithelium, and there has been no recurrence to date.View full abstractDownload PDF (4552K) -
Tomofumi NARUSE, Shin-ichi YAMADA, Souichi YANAMOTO, Akiko KAWAKITA, Y ...2014 Volume 60 Issue 4 Pages 234-239
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSWe describe our experience with a case of difficult-to-treat severe odontogenic infection in patient who presented with manifestations of Lemierre’s syndrome.
A 58-year old man was referred to our hospital because of swelling of the right side of the face. On the basis of imaging findings, right facial cellulitis and necrotizing fasciitis were diagnosed. Surgical drainage was peformed four times, and antibiotics were given for 8 weeks. Moreover, internal jugular vein thrombosis with distant infection occurred, and clinical findings revealed Lemierre’s syndrome. We there fore additionally administered anticoagulant therapy. Our experience shows that a multi-discliplinary team approach is required for the treatment of patients with underlying diseases.View full abstractDownload PDF (3059K) -
Koichiro KATO, Yoshiyuki MORIYA2014 Volume 60 Issue 4 Pages 240-244
Published: April 20, 2014
Released on J-STAGE: May 28, 2015
JOURNAL FREE ACCESSMetastatic tumors of the oral cavity are relatively rare. We report a case of hepatocellular carcinoma with metastasis to the condylar head of the mandible as the initial manifestation. The patient was a 54-year-old man who had an elastic hard mass, measuring 40 × 35 mm, in the left preauricular region. Although the lesion was histopathologically diagnosed as metastatic hepatocellular carcinoma on a biopsy, a primary lesion was not initially detected in the liver. Enlargement of the primary lesion was detected 4 months after the first visit, and the final diagnosis was made. The size of the condylar head lesion was reduced by radiotherapy with 30 Gy. There has been no evidence of recurrence as of 1 year after radiotherapy.View full abstractDownload PDF (2475K)
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